2025/02/05 by Saied Ali, Aideen Tobin, Susan Lapthorne +4 · 1 voice
Biochemistry, Genetics and Molecular Biology · Immunology and Microbiology · Medicine · #Antibiotic Resistance in Bacteria #Antibiotic Use and Resistance #Urinary Tract Infections Management
paper · doi:10.1099/jmm.0.001955
openalex publication_date 2025/02/05 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/02
Introduction. Carbapenems are usually employed as first-line antimicrobials against bacteria harbouring extended-spectrum beta-lactamases (ESBLs). These enzymes confer resistance often to multiple classes of antimicrobials. Hypothesis/Gap Statement. This indiscriminate use of carbapenems and the inevitable development of carbapenem resistance have prompted the need for carbapenem-sparing strategies. Methodology. The non-carbapenem antimicrobial susceptibility patterns of 60 ESBL-producing Enterobacterales (ESBL-PE) isolates responsible for bloodstream infections, in 2022–2023 inclusive, processed at our institution were reviewed. Results. The non-carbapenem antimicrobial susceptibility patterns of 60 ESBL-PE isolates from bloodstream infections during the study period were determined. Escherichia coli was the most common species isolated (87%, n =52), with the majority of cases (73.3%, n =44) originating from a presumed urinary source. Temocillin (TMC), mecillinam (MEC), cefiderocol (FDC), amikacin and fosfomycin (FOS) displayed excellent activity against all ESBL-PE isolates tested, with susceptibility rates of≥85%. Ciprofloxacin and amoxicillin–clavulanic acid were the least efficacious agents, with susceptibility rates≤20%. Conclusions. TMC, MEC, FDC and FOS offer promising alternatives to carbapenems, demonstrating efficacy against ESBL-PE. The use of these agents not only broadens the therapeutic arsenal against ESBL-PE but also mitigates the potential for escalating carbapenem resistance, especially in regions where the incidence of carbapenem resistance is increasing.